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KMID : 0356720030190060379
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Journal of the Korean Society of Coloproctology
2003 Volume.19 No. 6 p.379 ~ p.385
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Characteristic Clinical Behaviors of and Prognosis for Mucinous Adenocarcinomas in the Colon and Rectum
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Yoo Yuen-Sik
Kim Hee-Cheol
Park Sang-Jun
Yoo Jang-Hak
Kim Jung-Sun
Lee Kang-Hong
Yu Chang-Sik
Kim Jin-Cheon
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Abstract
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Purpose: The clinical significance of a mucinous-type colorectal adenocarcinoma is still controversial. Mucinous colorectal adenocarcinomas have been suggested to have distinct clinicopathologic features, i.e., early-onset, right-side dominancy, and poor prognosis. We aimed to verify the biological behaviors of and survivals for mucinous adenocarcinomas compared with non-mucinous adenocarcinomas.
Methods: Using a database of colorectal cancers at Asan Medical Center between 1989 and 2000, we enrolled 121 mucinous adenocarcinoma and 2,289 non-mucinous adenocarcinoma patients in this study. Clinical, pathological characteristics of and prognoses for mucinous adenocarcinomas were analyzed and compared with those for non-mucinous adenocarcinomas, retrospectively. The median follow-up period was 24 (0～113) months for mucinous adenocarcinomas and 32 (0～130) months for non-mucinous adenocarcinoma.
Results: Compared to non-mucinous adenocarcinomas, mucinous adenocarcinomas showed distinctive clinicopathologic features of early-onset (P＜0.001), frequent family history (P＜0.001), right-side dominancy (P=0.010), advanced stage at diagnosis (P＜0.001), and common peritoneal seeding at diagnosis (P＜0.001). The recurrence rate in the mucinous adenocarcinoma group was 45.2% during the follow-up period: 21.6% distant metastasis, 14.3% peritoneal dissemination, 5.7% local recurrence, and 3.6% simultaneous local recurrence and distant metastasis. The five-year survival rates in stages II and III were 70% and 48.7%, respectively, for mucinous adenocarcinomas and 92% and 50.2%, respectively, for non-mucinous adenocarcinomas. This difference was statistically significant.
Conclusions: Mucinous adenocarcinomas seem to have distinct biologic behaviors with different clinicopathologic features and poor prognosis. A surgical approach with a follow-up schedule considering the characteristics of mucinous adenocarcinomas is needed. J Korean Soc Coloproctol 2003;19:379-385
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KEYWORD
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Colorectal neoplasms, Adenocarcinoma Mucinous, Prognosis, Survival rate
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